Effect of hyaluronan on periodontitis: A clinical and histological study

Gauri Gontiya, Sushama R Galgali, Gauri Gontiya, Sushama R Galgali

Abstract

Background: Conventional, non-surgical periodontal therapy consists of supra- and subgingival tooth debridement. However, it is a technically demanding procedure and is not always efficient at eradicating all periodontal pathogens and in reducing inflammation. Therefore, local subgingival application of other chemotherapeutic agents may be used as an adjunct to non-surgical therapy. The aim of this study was to investigate the clinical and histological outcomes of local subgingival application of 0.2% hyaluronic acid gel (GENGIGEL®) as an adjunct to scaling and root planing (SRP) in chronic periodontitis patients.

Materials and methods: One hundred and twenty sites were chosen from 26 patients with chronic periodontitis (criteria being periodontal pockets ≥5mm). Experimental sites additionally received HA gel subgingivally at baseline, 1(st), 2(nd), and 3(rd) week. Clinical parameters were re-assessed at 4(th), 6(th), and 12(th) week. At 4(th) week recall, a gingival biopsy was obtained from test and control site for histologic examination.

Results: Intra-group analysis of all the clinical parameters at all sites from baseline to 4(th), 6(th), and 12(th) week showed statistically significant changes. Experimental sites showed statistically significant improvement in Gingival index and Bleeding index at 6(th) and 12(th) week when compared with control sites. However, no statistically significant differences were observed in the PPD and RAL between control and experimental sites at 4(th), 6(th), and 12(th) week time interval. No statistically significant association was found between the histological grading of the sites that received HA treatment.

Conclusion: Subgingival placement of 0.2% HA gel along with SRP provided a significant improvement in gingival parameters. However, no additional benefit was found in periodontal parameters. Histologically, experimental sites showed reduced inflammatory infiltrate, but it was not statistically significant.

Keywords: Gingival biopsy and inflammatory infiltrate; hyaluronic acid gel; scaling and root planing; subgingival application.

Conflict of interest statement

Conflict of Interest: None declared

Figures

Figure 1
Figure 1
Structure of hyaluronan molecule
Figure 2
Figure 2
Hyaluronic acid gel, Gengigel®
Figure 3
Figure 3
Subgingival application of Gengigel®
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Figure 4
Absent inflammatory infiltrate
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Figure 5
Slight inflammatory infiltrate
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Figure 6
Moderate inflammatory infiltrate
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Figure 7
Intense inflammatory infiltrate
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Figure 8
Clinical parameters at test site at baseline
Figure 9
Figure 9
Clinical parameters at test site at 4th week
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Figure 10
Clinical parameters at test site at 6th week
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Figure 11
Clinical parameters at test site at 12th week
Figure 12
Figure 12
Distribution of samples
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Figure 13
Changes in gingival index scores
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Figure 14
Mean gingival index
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Figure 15
Changes in bleeding index scores
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Figure 16
Mean bleeding index
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Figure 17
Changes in probing pocket depth
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Figure 18
Mean probing pocked deapth
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Figure 19
Changes in relative attachment level
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Figure 20
Mean relative attachment level
Figure 21
Figure 21
Histological assessment of inflammatory infiltrate

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